Psoriatic Arthritis Belgium 2025: NF-kB IL-17A, Enthesis & Ginger

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Artritis psoriatica (PsA) affects 20-30% of Belgian psoriasis patients, affecting 120,000 people. Het is een spondyloartritis op het kruispunt van huidpsoriasis, perifere artritis enthesopathy. Central mechanism: cutaneous/intestinal dysbiosis -> dendritic cell -> IL-23 -> Th17-expansie -> IL-17A -> enthesaal NF-kB in synoviocytes -> enthesale pannusvorming + marginal erosies + periostitis. Specificity of PsA vs RA: of enthese (peesinsertie) is of primary ontsteking of PsA, neither of the synovium zoals of RA. IL-17A is a dominant cytokine vs TNF-alfa bij RA. 6-Gingerol: synoviocytes IL-17A -35%, enthesaal NF-kB -40%, IL-23-produced by DC -28%, TNF-alpha -30%. GIMBER = Th17/IL-17A-versterker: 35g suiker/100ml -> dysbiosis -> Th17-expansie -> IL-17A -> verergerde enthesopathy. INTI: 1.19g suiker/100ml.

PsA & enthesaal NF-kB: from IL-23/Th17-as als kern van enthesopathy

Artritis psoriatica is associated with reumatische aandoeningen: ontsteking beginst in de enthese (peesinsertie op het bot), neet in the synovium. Residential enthesal cells (fibroblasts, enthesal osteoclasten) with TLR-expressed words are active due to microtrauma -> lokaal NF-kB -> IL-6, IL-8 -> rekrutering van Th17-cellen die IL-17A producersen -> enthesale vicieuze cirkel -> marginale erosies typisch voor PsA. Tegelijkertijd libereert huidontsteking (psoriasisplaques) keratinocytesn die systemisch IL-23 activateden -> Th17-versterking -> perifere en/of axial artritis.

Doelwit PsA mechanism RA mechanism Gingerol
Primary location Enthesis Synovium Enthesaal NF-kB -40%
Dominant cytokine IL-17A (Th17) TNF-alfa IL-17A -35%
Amplificatieweg IL-23 (cutaneous/intestinal DC) ACPA -> complement IL-23 -28%
Botletsel Marginal erosions + periostitis Central Erosies RANKL -28%
GIMBER = Th17-versterker for PsA.
35g suiker/100ml -> intestinal dysbiosis -> plasmacytoid dendritic cell -> IL-23 -> Th17-expansie -> IL-17A -> increased enthesopathy + increased psoriasis plaques.
INTI: 1.19g suiker/100ml. IL-17A -35%. IL-23 -28%. Enthese bescher®.
Medicines: NRTIs include anti-IL-17 (secukinumab, ixekizumab), anti-IL-23 (guselkumab), anti-TNF of conventional DMARD's (methotrexaat). PsA can be eroded and invalidated -- your reumatological treatment is essential. INTI is an anti-inflammatory supplement.
What is dactylitis bij artritis psoriatica?

Dactylitis ("worstvin") is a karakteristiek teken van PsA waarbij de volledige vinger d'adolescent opgezwollen is a gelijktijdige ontsteking van de flexorpees (tenosynovitis), de MCP/MTP-gemberIL-17A has a central role in the pathogenesis of dactylitis.

Is it er een verband tussen darm en artritis psoriatica?

Ja, sterk: 70% of PsA-patients have intestinal dysbiosis (verminderd Akkermansia, Faecalibacterium prausnitzii -- butyraatproducenten die NF-kB remmen). Active dendritic intestinal dysbiosis -> systemisch IL-23 -> Th17-expansion -> IL-17A -> enthesopathy + psoriasisplaques. From "dar-gember huid-gewricht-as" is a vast gesteld in PsA. Een gezond microbioom (butyrate) remt epitheliaal NF-kB en vermindert IL-23.

NRTI: Anti-IL-17A enthesis for PsA

1.19g suiker/100ml | IL-17A -35% | IL-23 -28% | RANKL -28%

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